Justin Diedrich, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

A114859 Issued in CA

Practice address

29525 Canwood St Ste 220
Agoura Hills, CA 91301-4231

Phone

(818) 722-3262

Fax

(818) 584-8882

NPI assigned

Aug 28, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.diedrich.p1@direct.ppgt.nextgenshare.com
• Direct secure messaging: justin.diedrichmd.p1@direct.ppmarmonte.nextgenshare.com
• Direct secure messaging: justin.diedrichmd.p1@direct.plannedparenthoodla.nextgenshare.com
• Direct secure messaging: jdiedrich100904@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Planned Parenthood Pasadena and San Gabriel Valley Inc

  • Community Health Clinic/Center
  • Pasadena, CA
  • NPI 1073669040

  CA

  Medicare reassignment NPD
• Regents of the University of California

  • Obstetrics & Gynecology Physician
  • Orange, CA
  • NPI 1356304034

  CA, Obstetrics & Gynecology

  Medicare reassignment NPD
• University of California Irvine

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1598790529

  CA

  Medicare reassignment NPD
• Planned Parenthood Pasadena and San Gabriel Valley Inc

  • Community Health Clinic/Center
  • Baldwin Park, CA
  • NPI 1710537303
  NPD
• University of California Irvine

  • Pharmacy
  • Irvine, CA
  • NPI 1669344339
  NPD
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • San Jose, CA
  • NPI 1043263189
  NPD (past)
• Planned Parenthood/Orange and San Bernardino Counties, Inc.

  • Clinic/Center
  • Anaheim, CA
  • NPI 1710975727
  NPD (past)
• Sharp Memorial Hospital

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)
• Planned Parenthood of Greater New York Inc

  • Ambulatory Family Planning Facility
  • Brooklyn, NY
  • NPI 1417959701
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1396978037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST STE 220",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014231",
            "telephone_number": "818-722-3262",
            "fax_number": "818-584-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST STE 220",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014231",
            "telephone_number": "818-722-3262",
            "fax_number": "818-584-8882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1873 Commercenter W",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083303",
            "country_code": "US",
            "telephone_number": "714-922-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEDRICH",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-28",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A114859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristina Dino
• Shannon M Dobbs, PSY.D.
• Jean Doh, PHARMD, BCOP
• Elizabeth Ruslana Dolbaya, FNP

• All providers in Agoura Hills, CA
• Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.